(1/32) Functional electrical stimulation reinforced tenodesis effect controlled by myoelectric activity from wrist extensors.
We demonstrated a method for enhancing the tenodesis grip in individuals with sustained tetraplegia at the 6th cervical vertebra neurological level. Subjects used the myoelectric activity from wrist extensor muscles to directly control the electrical stimulation of the extrinsic finger and thumb flexors (flexor pollicis longus and flexor digitorum superficialis/ profondus) with the use of a specially designed system, Myoelectrically Controlled Functional Electrical Stimulation (MeCFES). We screened 20 medical records and selected 9 subjects. Of the nine subjects, five showed a positive response to the surface stimulation and could test the system; the other four failed to achieve functional finger flexion because of skin sensitivity or inadequate movement. We evaluated hand function, with and without the MeCFES system, using tests involving three everyday objects: manipulating a videocassette with the key grip, drinking from a bottle with the palmar grasp, and writing with a pen using the tripod grip. Without the system, none of the five subjects could complete all three tasks; but, when assisted with MeCFES, all subjects completed all the tasks. The system proved simple and intuitively easy to use, and no training was needed for subjects to obtain immediate functionality. We will need further research to evaluate the usefulness of the system in activities of daily living. (+info)
(2/32) To detach the long head of the biceps tendon after tenodesis or not: outcome analysis at the 4-year follow-up of two different techniques.
The aim of this study was to determine whether or not detaching the biceps tendon from the glenoid after tenodesis performed with the inclusion of the biceps in the rotator cuff suture results in an improved outcome. From 1999 to 2001, 22 patients had an arthroscopic rotator cuff repair and associated biceps tendon lesions that were repaired with two new arthroscopic techniques of tenodesis incorporating the biceps tendon in the rotator cuff suture. Patients were randomised into one of two groups: tenodesis without tenotomy (group 1) and tenodesis with tenotomy (group 2). Preoperative and postoperative functions were assessed by means of a modified UCLA rating scale and shoulder ROM. The mean follow-up period was 47.2 months (range 36- 59). In group 1 (tenodesis without tenotomy), eight patients had an excellent postoperative score and three a good postoperative score. The UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative average rating of 10.5 (5-15) to the postoperative average score of 33 (29-35) (P<0.05). In group 2 (tenodesis with tenotomy), the UCLA rating system used for evaluation showed a statistically significant improvement from the preoperative rating of 11.1 to the postoperative score of 32.9 (P<0.05). No statistically significant difference in the total UCLA scores was found when comparing the repairs performed with or without tenotomy. Follow-up results with regard to ROM were not different between the two groups, and the range of motion was improved in all measured directions. In this series, every patient qualified as having good to excellent results according to the UCLA score. This study suggests that there is no difference between detaching and not detaching the biceps after including it in the repair. (+info)
(3/32) Arthroscopic synovectomy, removal of loose bodies and selective biceps tenodesis for synovial chondromatosis of the shoulder.
We retrospectively identified 18 consecutive patients with synovial chrondromatosis of the shoulder who had arthroscopic treatment between 1989 and 2004. Of these, 15 were available for review at a mean follow-up of 5.3 years (2.3 to 16.5). There were seven patients with primary synovial chondromatosis, but for the remainder, the condition was a result of secondary causes. The mean Constant score showed that pain and activities of daily living were the most affected categories, being only 57% and 65% of the values of the normal side. Surgery resulted in a significant improvement in the mean Constant score in these domains from 8.9 (4 to 15) to 11.3 (2 to 15) and from 12.9 (5 to 20) to 18.7 (11 to 20), respectively (unpaired t-test, p = 0.04 and p < 0.0001, respectively). Movement and strength were not significantly affected. Osteoarthritis was present in eight patients at presentation and in 11 at the final review. Recurrence of the disease with new loose bodies occurred in two patients from the primary group at an interval of three and 12 years post-operatively. In nine patients, loose bodies were also present in the bicipital groove; seven of these underwent an open bicipital debridement and tenodesis. We found that arthroscopic debridement of the glenohumeral joint and open debridement and tenodesis of the long head of biceps, when indicated, are safe and effective in relieving symptoms at medium-term review. (+info)
(4/32) Ligament reconstruction versus distal realignment for patellar dislocation.
(5/32) Reconstruction technique affects femoral tunnel placement in ACL reconstruction.
(6/32) Soft tissue tenodesis of the long head of the biceps tendon associated to the Roman Bridge repair.
(7/32) A simple grafting method to repair irreparable distal biceps tendon.
(8/32) Interference screw vs. suture anchor fixation for open subpectoral biceps tenodesis: does it matter?